The president of the Australian Medical Association, Dr Omar Khorshid, says he does not endorse the prime minister’s announcement that anyone under 40 can receive the AstraZeneca vaccine from their GP, adding it took him by surprise.
The advice from the independent Australian Technical Advisory Group on Immunisation – that Pfizer is the preferred vaccine for under-60s due to an increased risk of rare clotting events linked to the AstraZeneca jab – is unchanged. Despite this, Scott Morrison on Monday night encouraged under-60s “to go and have that discussion with your GP” if they wish to receive the AstraZeneca vaccine.
“It took us by surprise, and it’s hard to know how to take that announcement because I think it’s going to be a limited number of people to take it up, given that they would be going against the expert Atagi recommendation,” Khorshid told Guardian Australia on Tuesday.
“Our recommendation is still really for patients to follow the Atagi advice. Be patient and have the Atagi-recommended vaccine when it’s available. I am certainly still backing the expert advice at this stage.”
Atagi is comprised of independent infectious diseases physicians, microbiologists, epidemiologists, public health nurses, GPs and consumer representatives. Its advice states there is “a higher risk and observed severity of thrombosis [clotting] and thrombocytopenia [low platelet count] syndrome related to the use of AstraZeneca Covid-19 vaccine observed in Australia in the 50-59 year old age group than reported internationally and initially estimated in Australia”.
Asked why he thought the government had made the announcement without informing the AMA, given that doctors will now be responsible for administering the AstraZeneca vaccine to under-60s who want it and leading discussions about risk, Khorshid said: “My guess is that they are wanting to provide nervous Australians who are going into lockdown this week with something that they can actually do to improve their chances of getting through this and to push the nation’s vaccination program forward.
“We do have surplus doses that are currently not being used so there is some capacity to bump up the delivery. Of course, if Delta really does ingrain itself in our community and the lockdowns aren’t successful or they’re too slow, then speeding up the vaccination program by using more options on the table is wise. The problem, of course, unfortunately, is that for the Delta virus you need both doses to get reasonable protection against Delta and for AstraZeneca, that’s a minimum of eight weeks apart.”
Khorshid said a priority for the AMA in light of Monday night’s announcement would be extending the new Medicare item number which covers consultations with a GP about the vaccine to include other age groups. The item number now only applies to those over 50.
“I’ve spoken to the chief medical officer and I understand he’s going to get some advice out as soon as it is written to GPs,” Khorshid said. “We need to patch that little hole, fairly promptly.”
Others shared Khorshid’s concern about the government’s advice. Queensland’s chief health officer, Dr Jeannette Young, said the clinical advice was clear.
“So the clinical advice from Atagi is that people under the age of 60 should preferentially get Pfizer,” she said. “The advice in the UK is that people under the age of 40 should get Pfizer. That’s the clinical advice, but there are some people who have been asking to get AstraZeneca although the clinical advice is that they should not preferentially should not.”
There are some vaccination clinics that have been offering the AstraZeneca vaccine to those under-60 who want it, so long as they understood the risks, even before the prime minister’s press conference, because of excess supply and patients saying they just wanted to be vaccinated given that the risk of the rare clotting is so low.
Victoria’s health minister, Martin Foley, said those aged 18 to 39 needed to be patient if they did decide to take the AstraZeneca vaccine through their GP. This follows reports from GPs that they were unprepared for the announcement.
“There’s a degree of confusion out there with the GPs, as we seek to roll this out,” Foley said. “As soon as we get all the information and clarification from the commonwealth, we will implement the system as quickly and as smoothly as we possibly can.”